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Abstract

Background: With a US prevalence of 795,000 strokes per year and stroke recurrence rates up to 20%, the objective of this study was to determine the prevalence of prescription medication use for secondary stroke prevention and vascular risk factor modification among noninstitutionalized US adults and compare medication use in Whites and Blacks.

Methods: A cross-sectional study was performed as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010. Demographic, disease, and prescription medication use were obtained via a standardized interview. Participants were asked if they had ever been told by a health professional that they had hypertension, diabetes, high cholesterol, or a stroke. Additionally, participants were asked if they had taken or used any prescription medicine in the past month as well as the names of each prescription medication. Statistical analyses used NHANES sample weights to provide prevalence estimates for the US population.

Results: Among 11,375 participants (21% Black, 47.6% men, age 20-80), medication use for secondary stroke prevention and vascular risk factors remained low (Table 1). Participants who reported taking either an antiplatelet agent or an anticoagulant with a history of stroke remained low (7.9% Whites vs 6.2% Blacks). More Blacks with hypertension reported taking blood pressure lowering agents (38.9 vs 36.1% Whites). Diabetic medication use was lower in Blacks reporting a history of diabetes (24.5 vs 25.7% Whites). Medication use rates were lowest in participants reporting high cholesterol, with more Whites reporting use of a cholesterol lowering medication (19.3 vs 14.6%; p<0.001).

Conclusion: Despite the prevalence of stroke and vascular risk factors, only a small proportion of people at risk are on medications for secondary stroke prevention and vascular risk factor modification. Overall, Blacks were taking fewer medications for secondary stroke prevention and vascular risk factor modification with the exception of anti-hypertension medication.